renal tubular disease Flashcards

1
Q

what is renal tubular acidosis?

A

Impaired acid excretion → hyperchloraemic met acidosis

Both → RAS activation → K+ wasting and hypokalaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the types of renal tubular acidosis?

A

type 1- distal
type 2- proximal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is type 1 renal tubular disease?

A

distal
inability to excrete H+ even when acidotic
may complicate other renal disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the causes of type 1 renal tubular disease?

A

Hereditary: Marfan’s, Ehler’s Danlos
AI: Sjogren’s, SLE, thyroiditis
Drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the features of type 1 renal tubular disease?

A

Rickets / osteomalacia (bone buffering)

Renal stones and UTIs

Nephrocalcinosis → ESRF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how is type 1 renal tubular acidosis diagnosed?

A

failure to acidify urine ph>5.5 despite acid load

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is type 2 renal tubular acidosis?

A

proximal

Defect in HCO3 reabsorption in PCT

Tubules can reabsorb some HCO3 so can acidify urine in
systemic acidosis when HCO3 ↓

Usually associated w Fanconi syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how do you diagnose type 2 renal tubular acidosis?

A

urine will acidify with acid load pH<5.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is fanconi syndrome?

A

Disturbance of PCT function → generalised impaired reabsorption
 amino acids, K+, HCO3, phosphate, glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the causes of fanconi syndrome?

A

Idiopathic
Inherited: inborn errors, Wilson’s
Acquired: tubule damage - drugs, myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are features of fanconi syndrome?

A

Polyuria (osmotic diuresis)

Hypophosphataemic rickets (Vit D resistant)

Acidosis, ↓K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are hereditary hypokalaemic tubulopathies?

A

bartter’s syndrome
gitelman syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is bartter’s syndrome?

A

Blockage of NaCl reabsorption in loop of Henle (as if taking frusemide)

Congenital salt wasting → RAS activation → hypokalaemia and metabolic alkalosis

Normal BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is giltelman syndrome?

A

blockage of nacl reabsorption in DCT as if taking thiazides

congenital salt wasting -> RAS activation -> hypokalaemia + metabolic acidosis + hypocalciuria

normal BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly